Individual provider Active NPI

Shailesh B. Shah, MS, RPH

  • Pharmacist
  • Newark, NJ
National Provider Identifier
1518005115
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
26RI01963800 Issued in NJ
Practice address
570 Bloomfield Ave
Newark, NJ 07107-1346
Phone
(973) 482-6753
Fax
(973) 482-0356
NPI assigned
Feb 3, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 26RI01963800 NJ Primary

Addresses

Primary practice location

570 Bloomfield Ave
Newark, NJ 07107-1346

Mailing address

25 Yale CT
Livingston, NJ 07039-1519
Phone (973) 533-0269

Other identifiers 1

IdentifierTypeStateIssuer
26RI01963800OtherNJPHARMACIST LIC#

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science, Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
26RI01963800NJMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Ambacare Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1518005115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 YALE CT",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070391519",
            "telephone_number": "973-533-0269",
            "fax_number": "973-533-0369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "570 BLOOMFIELD AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071071346",
            "telephone_number": "973-482-6753",
            "fax_number": "973-482-0356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "SHAILESH",
        "middle_name": "B.",
        "name_prefix": "Mr.",
        "credential": "MS, RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "26RI01963800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST LIC#",
            "identifier": "26RI01963800",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.